: Hyperpigmentation is most common cutaneous manifestation in pregnancy due to elevated serum levels of melanocyte stimulating hormones, estrogen or progesterone. Estrogen increases the output of melanin by the melanocytes and the effect of estrogen is augmented by progesterone, resulting in melanin deposition into epidermal cells and dermal macrophages, clinically either generalized hyperpigmentation or more commonly areas that are already physiologically dark become more obvious such as areolas, nipples, genitalia, axillae, periumbilical area, and inner thighs. Linae nigra, melasma, and longitudinal melanonychia are also more common with pregnancy. Assessment of hyperpigmentation during pregnancy in the third trimester in relation to foetus gender. A cross sectional study and convenient sampling method included all primigravida ladies in the third trimester were carried out. 309 pregnant ladies were collected from Al-Kindy teaching hospital, Al-mustanseryah and Bab Al-muatham primary health care centres during period from first of October 2018 till 29th of february 2020. Direct interview was made with pregnant ladies and check list was fulfilled. There was no significant correlation between foetus gender and development of melasma and melanonychia in pregnant ladies with p values 0.426 and 0.074 respectively, while there was significant correlation between foetus gender and the development of linea nigra, hyperpigmentation of areolas and flexures and generalized pigmentation in pregnant ladies with male foetuses with p value 0.018, 0.001 and 0.001 respectively. Hyperpigmentation was more in pregnant ladies with male foetuses than female foetuses.